Sciatica Solution

Our SCIATICA SOLUTION exercise program is designed specifically for Sciatica. It takes you from the basic building blocks to higher-level exercises to strengthen your body and help minimize your risks of re-injury. These exercises are arranged in the order of easiest to most difficult.

Of course, there are many recommendations and beliefs out there, and it’s hard to tell which are right for you, or for that matter, right at all! What I can assure you with our program and recommendations, is that they are based on over 95 combined years of experience in the field of physical therapy (and counting), as well as extensive research on studies and outcomes of different treatment approaches.

Please feel free to familiarize yourself with these exercises, but please do NOT perform any that cause you more pain. Also, please read about the RED and YELLOW flags. If you fall into any of the categories listed, our recommendation is to seek immediate medical attention.

I also want to remind you that if you have ANY questions or concerns on how to do the exercises, that professional advice is only a phone call away, and it is FREE. We want to help you get this right so that you will avoid the dangers associated with going untreated or not understanding fully what you need to do and how to do it. Consider us your guides to better health.

If you are unsure whether you have sciatica, we’ve researched the most effective means of identifying IF sciatica is related to a herniated or bulging disc (HNP) and developed a system of self-tests and a questionnaire, that together, can reliably predict if that is the case for you. If you would like to take the self-tests and questionnaire, please click on the links above.

Direction of Preference

DIRECTION OF PREFERENCE can be simply put as the movement that gets rid of the symptoms or is best tolerated. In the case of sciatica caused by a herniated disc, the initial movement is into extension, which is demonstrated in the following exercises.

Prone on Elbows Exercise

Prone Press Up Exercise

Standing Back Bend Exercise

Body Mechanics

Functional Sit To Stand

Standing from a Chair – Seek chairs that are not too soft with seats are relatively high off the ground and arm rests as these will be the easiest to rise from. Begin by sitting in a chair with your arms on the arm rests. Scoot your bum forward to the front of the chair and tuck your feet hip-width apart and as far under you while still able to keep them flat on the ground. Lean forward at your hips—keep your back from rounding—so your nose is over your toes and push equally through the heels of both feet into a standing position, using your arms to push down on the armrests as needed*. Once standing, make sure you don’t lock your knees. *Ideally you don’t want to use your arms when standing from a chair.

Hip Hinge

Bending Forward Using Your Hips (Hip Hinge) – Beginning in an upright standing position, slowly bend forward at your hips, bending your knees only if you have to, making sure you keep your back straight. This may feel very foreign to you and initially it may be helpful to hold a broomstick with one hand at the back of your head and the other behind your rear end. This will keep your spine straight while you bend forward from the hips.

Lifting

Safe & Proper Lifting Techniques – Make sure the object is not too heavy. If lifting from the floor, use your foot to get a sense of how heavy it is. If it is too heavy, ask for help. Step close to the object so it is right in front of you. With feet flat on the floor, squat down (see instruction on Squats under strengthening exercises) to allow your hands to reach the object. Keeping the object close to your body, lift the object to waist level by pushing through your heels to straighten your knees and hips. To turn with the object, make sure that you do not twist your back—move your feet and hips in the direction you want to go.

Log Rolling

Rolling in Bed (like a Log) – The goal of log rolling is to keep your spine straight and avoid twisting your back. Begin by laying on your back and bend both knees up. When turning to your left, push down through the right foot and reach across your body with your right arm until you roll onto your side. Reverse the process when turning to your right. Make sure you keep your abdominal muscles tight so that you roll as one unit like a log. To do this, pull your belly button in and hold.

Postural Education

Walking Program

It is important to resume gentle activity as quickly as possible. Try to walk for 30 minutes. This can be divided into 2 15-minute walks or shorter duration as tolerated. The pace should be as quick as you are able to tolerate, as long as it does not set off pain. If the pain is provoked or increased, then slow down. Stop walking if symptoms increase or persist, and don’t overextend yourself. Increase a little at a time and try to extend the walking time to 45 minutes.

Core Stabilization 1

All of the following exercises (C1-4) should be performed in a neutral spine position. To find your neutral spine, lie on your back with your knees bent. Arch your back as far as you can, now reverse your movement to eliminate the arch. The point midway between the two is YOUR “neutral spine” i.e. comfortable point between the two extremes.

CS-1 – Prone Hollowing

CS-1- Prone Hollowing – Lie on your stomach. Tighten your lower abdominals as if you were pulling your belly up and away from the front of your pants.

CS-1 – Supine Hollowing

CS-1- Supine Hollowing – Lie on your back with your knees bent and in a neutral spine, meaning a comfortable position for you and without arching your low back. Tighten your lower abdominals as if you were pulling your belly away from the front of your pants.

CS-1 – Quadruped Hollowing

CS-1- Quadruped Hollowing – Get into all fours with your hands directly below your shoulders and your knees directly below your hips. First allow your belly to hang loose, then tighten your lower abdominals as if you were pulling your belly up and away from the front of your pants.

Core Stabilization 2

CS-2-Hook Lying Knee Squeeze

CS-2-Hook Lying Knee Squeeze – Lie on your back with your knees bent and feet flat on the surface you are laying on. Squeeze your knees together while tightening your abdominals as if you are bringing your belly button away from your pants. Then contract the muscles of your pelvic floor (pretend you are trying to stop your urine flow).

CS-2-Prone Arm Raise

CS-2-Prone arm raise – Lie on your stomach with your arms extended overhead. Tighten your lower abdominals as if you were pulling your belly up and away from the front of your pants while keeping your hips flat on the table. Then lift one arm approximately 2-4 inches off the table. DO NOT ARCH YOUR BACK. Return to the starting position and repeat using your opposite arm. Pretend you have a hot cup of water on your low back that you don’t want to spill as you move each of your arms.

CS-2-Prone Leg Raise

CS-2-Prone leg raise – Lie on your stomach with your arms by your side. Tighten your lower abdominals as if you were pulling your belly up and away from the front of your pants while keeping your hips flat on the table. Then lift one leg approximately 2-4 inches off the table. DO NOT ARCH YOUR BACK. Return to the starting position and repeat using your opposite leg. Pretend you have a hot cup of water on your low back that you don’t want to spill as you move each of your legs.

CS-2-Supine March

CS-2-Supine March – Lie on your back with your knees bent and your feet flat on the surface you are lying on. Perform supine hollowing and then alternate lifting your left and right foot all while maintaining the hollowing.

Core Stabilization 3

CS-3-Quadruped Arm Raise

CS-3-Quadruped arm raise – Get into all fours with your hands directly below your shoulders and your knees directly below your hips. First allow your belly to hang loose, then tighten your lower abdominals as if you were pulling your lower belly up and away from the front of your pants without arching your low back to maintain your neutral spine. Then lift and extend one arm out in front of you with a goal of full arm extension. DO NOT ALLOW YOUR BACK TO ARCH. Repeat back and forth alternating arms.

CS-3-Quadruped Leg Raise

CS-3-Quadruped leg raise – Get into all fours with your hands directly below your shoulders and your knees directly below your hips. First allow your belly to hang loose, then tighten your lower abdominals as if you were pulling your lower belly up and away from the front of your pants without arching your low back to maintain your neutral spine. Then lift and extend one leg out behind you with a goal of full leg extension. DO NOT ALLOW YOUR BACK TO ARCH. Repeat back and forth alternating legs.

CS-3-Basic Bridge

CS-3-Basic Bridge – Lie on your back with your knees bent and your feet flat on the table or surface you are lying on. Tighten your abdominals as if you were going to be punched in the stomach. Pressing your heels into the surface you are lying on, raise your hips off the table until your hips are straight. DO NOT ARCH YOUR BACK. Squeeze your buttocks at the same time and hold for 2 seconds. Return to the starting position.

CS-3-Prone Alternating Arm and Leg Lift

CS-3-Prone Alternating Arm and Leg Lift – Lie on your stomach with your arms extended overhead. Tighten your abdominals as if you were going to be punched in the stomach. Then lift your left arm and right leg at the same time approximately 4 inches off the table. Return to the starting position and repeat using your right arm and left leg together.

Core Stabilization 4

CS-4-Quadruped Arm and Leg Lift

CS-4-Quadruped alternating arm and leg lift – Get into all fours with your hands directly below your shoulders and your knees directly below your hips. First allow your belly to hang loose, then tighten your lower abdominals as if you were pulling your lower belly up and away from the front of your pants without arching your low back to maintain your neutral spine. Then lift your left arm and right leg at the same time approximately 2-4 inches off the table. DO NOT ARCH YOUR BACK. Return to the starting position and repeat using your right arm and left leg together. Pretend you have a hot cup of water on your low back that you don’t want to spill as you move your arm and leg.

CS-4-Lunge/High Kneel

CS-4-Lunge/High Kneel – Stand with your feet together. Step forward with your left leg and slowly lower yourself toward the ground by allowing your left knee to bend. The right knee should be allowed to bend as well. Make sure your left knee does not protrude further out than your toes and your back is straight. Return to the starting position by pressing off your left heel. Repeat the same motion on the right side.

CS-4-Standing Rotation

Standing Rotation – Perform hollowing. Keeping your torso straight, twist to the left by rotating only at the hips, not at the spine. Rotate back to the right and you have performed one repetition.

CS-4-Unilateral Bridge

CS-4-Unilateral Bridge – Lay on your back with your knees bent. Place your fingers on the pointy bones in the front of your pelvis. Extend your right leg out in front of you. Perform supine hollowing and then push your left heel into the surface you are laying on, lifting your hips up off the table until you’re straight from your shoulders to your knees. Use your hands to make sure your hip is not rotating. Lower yourself back down to the table and repeat. Repeat on the other side.

Dural Glides / Neural Mobilization

D1-Dural Glides For Sciatica In Supine Leg Extension

D1-Dural Glides For Sciatica In Supine Leg Extension Neural Mob

D1-Dural glides for sciatica-sitting slump

D1-Sitting Slump Neural Mob – (Tensioner) – Sit at the edge of a table or bed with both legs hanging off the edge. Clasp your hands together behind your back and slump forward bringing your chin toward your chest. Straighten one leg and alternate flexing and pointing your foot. You may feel a tight sensation in the back of your thigh. If you experience symptoms similar to the pain you have been feeling, don’t pull your foot up as high or bend your knee slightly. Continue until you feel your pain lessen. If your pain intensifies, then try the slider or flossing technique.

Slider/Flossing – Sit at the edge of a table or bed with both legs hanging off the edge. Clasp your hands together behind your back and slump forward bringing your chin toward your chest. Straighten one leg until you feel a tight sensation in the back of your thigh. At that point, bend your ankle upwards at the same time you look up. Then look down at the same time you bend your ankle down. You may feel a tight sensation in the back of your thigh but this should not increase pain in the back of your leg. If symptoms increase, don’t pull your foot up as high or try bending your knee slightly. Continue until you feel your pain lessen.

D2-Dural glides for sciatica with cervical flexion-flossing technique

D2-Dural Glides For Sciatica With Cervical Flexion – (Slider/Flossing) – Lie on your back. Bring your painful leg toward your chest, supporting it with your hands just below the knee. Straighten your knee until you feel pulling at the back of your thigh or mild symptoms. Then, at the same time, curl your chin toward your chest while pointing your toes toward away from you. Do not allow your symptoms to increase. Then, at the same time, look backward as you pull your toes toward you. Repeat this movement. Make sure to keep your motions smooth and continuous. Continue until your symptoms lessen.

D2-Dural Glides For Sciatica With Cervical Flexion – (Tensioner) – Lie on your back. Lift your painful leg toward your chest, supporting it with your hands just below the knee. Straighten your knee until you feel pulling at the back of your thigh or mild symptoms. At the same time, curl your chin toward your chest and bring your toes toward you at the same time. Then lower your head back down and point your toes. Repeat this movement. Make sure to keep your motions smooth and continuous.

Stretching

S1-hamstring stretching-doorway

S1-Doorway Hamstring Stretch 1 – (Lying down on the floor)
(For those that can get down to the floor and back up again safely.) Lie flat on the floor near a door frame, keeping your back straight and the opposite knee bent. With a straight leg, place the heel of your other foot along the door frame. If you feel a mild pulling sensation behind the knee, maintain that position for 30 seconds. If the sensation is too intense, move your body slightly away from the door frame. If you do not feel a stretch, scoot your bottom closer to the wall until you feel a pulling. Once you are able to bring your bottom all the way up against the door frame, start slowly straightening the opposite knee, until you finally can perform the stretch with your bottom against the door frame and your other leg straight on the ground.

S1-hip flexor stretching-Thomas test

S1-Thomas Stretch for Hip Flexors – (Lying down) – Lie on your back at the edge of a bed and bring both knees to your chest and hold them with your hands. Let go of the leg on the outside and let it hang off the side of the bed. Keep the other leg close to your chest. Lie on the other side of the bed to stretch the other leg.

S2-hamstring stretching-chair sitting

S2-Hamstring Stretching (Sitting In Chair) – Sit at the edge of a chair and straighten one leg out keeping the knee as straight as you can. Bend at the hips bringing your belly button toward your knee. (keep your back straight)

S2-hamstring stretching-long sitting

S2-Hamstring Stretching – (Sitting on the side of a bed/table) – Sit along the edge of a bed or sturdy table with one leg out in front of you and the other by your side supporting your weight slightly. Remember to keep your back straight and keep your knee down towards the table. Bend forward slowly bringing your belly button towards your knee only as far forward as you can until the stretch is felt.

S2-gastroc & soleus stretching

S2-Gastroc & Soleus Stretching – Also known as the calf muscles. There are 2 separate muscles, one that ends above the knee and one below. To target the gastroc(nemius) muscle, you must keep your knee straight. To target the soleus muscle, you will bend your knee and will feel the stretch lower in the leg towards your Achilles, or heel cord.

To stretch these, stand facing a wall. With your hands on the wall for balance, to stretch the muscle in the left leg, keep your right foot forward and move your left foot back. Keeping your heel on the ground, slowly slide your left foot further from the wall until you feel the pulling in your left calf. For the gastroc, keep the knee straight. You will feel the pulling higher up on your calf, just below your knee. To stretch the other muscle in your left calf (soleus), with your right leg forward and left leg slightly back, allow your left knee to slowly bend towards the floor until you feel the pulling towards your heel cord.

Reverse the legs to stretch the muscles in your right calf.

S2-Psoas Stretch-Standing

S2-Psoas Stretch-Standing – Stand facing a chair placing your left foot on top of the chair with your right leg on the floor behind you. Lean forward slightly making sure to keep your belly and butt tight (contracted). You should feel a stretch in the front of your right hip.

S3-Latissimus dorsi stretch

S3-Latissimus Dorsi Stretch – (Laying down) – Lie on a table or bed with your bent knees up. To stretch the left side you’ll bring your left hand behind your head placing your hand on the pillow. Then you’ll let your knees come towards to the right side until you feel a mild sensation of pulling extending from your arm to your low back. If this sensation of pulling goes away you can increase the intensity by extending your left arm and bringing it toward your opposite shoulder. You should only be feeling a mild sensation of pulling and you should maintain this for 30 seconds or longer. If the stretch is painful, back off.

S3-Latissimus dorsi stretch-quadruped

S3-Quadruped Latissimus Dorsi Stretch – (on hands and knees) – The following is another stretch to the latissimus dorsi which is the large muscle in your back. You’re going to start in a quadruped position which is on your hands and knees, and extend your arms out in front of you as far as you can reach. Then bring your bottom slowly down towards your heels. You should feel a mild sensation of pulling from your arms down to your low back. It should never be painful.

S3-Latissimus dorsi stretch-quadruped

S3-Quadruped Latissimus Dorsi Stretch – (on hands and knees) – The following is another stretch to the latissimus dorsi which is the large muscle in your back. You’re going to start in a quadruped position which is on your hands and knees, and extend your arms out in front of you as far as you can reach. Then bring your bottom slowly down towards your heels. You should feel a mild sensation of pulling from your arms down to your low back. It should never be painful.

If you feel a stretch of tightness on one side more than the other we are going to show you another way to increase the intensity on that side. Again, start in a quadruped position or on your hands and knees position. If the tightness is on the left side. Bring your hands in front of you. Cross your left arm over your right and bring your bottom toward your heels. All you should feel is a slight sensation of pulling on the left side primarily. Reverse if you have tightness primarily on the right.

S3-Rectus Femoris Stretch standing

S3-Rectus Femoris Stretch – (Standing with chair) – Stand with a chair behind you. Place your right foot on the back of the chair and then your right knee on the seat of the chair. Then lean back until you feel a stretch in the front of your thigh. The closer your knee is to the back of the chair the more of a stretch you will feel. Repeat on the left to stretch that leg.

Miscellaneous Exercises

Cat Camel Exercise

Cat Camel Stretch – Begin on all fours with your hands directly under your shoulders and your knees directly under your hips. Slowly round your entire back up towards the ceiling. Then allow your back to sag toward the table. Make sure you do these motions slowly.

Child’s Pose

Child’s Pose – Begin on all fours. Keeping your hands in place, bring your bum back toward your heels. You should feel a mild to moderate stretch throughout your back. It should never be painful. Hold for 30 seconds.

Lower (Lumbar) Trunk Rotation

Lower Trunk Rotation – Lie down on your back with both knees bent and held together with arms out from your sides. Slowly lower your knees to one side of the bed, allowing your hips and trunk to rotate. Repeat to the other side. Make sure your shoulder blades remain on the ground the entire time.

Dying Bugs

Dying Bugs – Begin by lying on your back with both your knees bent and arms down by your sides. Keeping your lower abdominals tight, lift one arm off the ground at the same time as the opposite leg, keeping your knees bent. Lower the arm and leg back to the ground and repeat with the opposite arm and leg. Keep your abdominals tight (by pulling your belly button in) throughout the exercise, keep your back from arching and make sure you’re not holding your breath. Pretend you have a hot cup of water on your belly that you don’t want to spill as you move your arm and leg.

Curl up

Curl Up – Lie on your back with your knees bent and arms crossed over your chest. Lift your head and shoulders up toward your knees and return to the initial position slowly. Do not allow your low back to flatten and make sure you don’t stick your chin out. This should not be confused with a sit up.